Association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome in Korean women with type 2 diabetes mellitus

BACKGROUND/OBJECTIVESThis study was aimed at examining the association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome (MetS) in Korean women with type 2 diabetes mellitus (T2DM).SUBJECTS/METHODSA cross-sectional analysis was performed among 502 female T2DM patients (non-MetS group; n = 129, MetS group; n = 373) who were recruited from the Huh''s Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) and the data was analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. The intake of flavanones was estimated on the basis of the flavonoid database.RESULTSIn the multiple linear regression analysis after adjustment for confounding factors, daily flavanones intake was negatively associated with CVD risk factors such as total cholesterol, LDL-cholesterol, and apoB and apoB/apoA1 ratio only in the MetS group but not in the non-MetS group. Multiple logistic regression analysis revealed that the odds ratio for a higher apoB/apoA1 ratio above the median (≥ 0.74) was significantly low in the 4^th quartile compared to that in the 1^st quartile of dietary flavanones intake [OR: 0.477, 95% CI: 0.255-0.894, P for trend = 0.0377] in the MetS group.CONCLUSIONSDietary flavanones intake was inversely associated with the apoB/apoA1 ratio, suggesting a potential protective effect of flavanones against CVD in T2DM women with MetS.     

Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke

The possible relationship between dietary cholesterol and cardiac outcomes has been scrutinized for decades. However, recent reviews of the literature have suggested that dietary cholesterol is not a nutrient of concern. Thus, we conducted a meta-analysis of egg intake (a significant contributor to dietary cholesterol) and risk of coronary heart disease (CHD) and stroke. A comprehensive literature search was conducted through August 2015 to identify prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke. Random-effects meta-analysis was used to generate summary relative risk estimates (SRREs) for high vs low intake and stratified intake dose–response analyses. Heterogeneity was examined in subgroups where sensitivity and meta regression analyses were conducted based on increasing egg intake. A 12% decreased risk (SRRE = 0.88, 95% confidence interval [CI], 0.81–0.97) of stroke was observed in the meta-analysis of 7 studies of egg intake (high vs low; generally 1/d vs <2/wk), with little heterogeneity (p-H = 0.37, I² = 7.50). A nonstatistically significant SRRE of 0.97 (95% CI, 0.88–1.07, p-H = 0.67, I² = 0.00) was observed in the meta-analysis of 7 studies of egg consumption and CHD. No clear dose–response trends were apparent in the stratified intake meta-analyses or the meta regression analyses. Based on the results of this meta-analysis, consumption of up to one egg daily may contribute to a decreased risk of total stroke, and daily egg intake does not appear to be associated with risk of CHD.

Key Teaching Points:

? The role of egg consumption in the risk of stroke and coronary heart disease has come under scrutiny over many years.

? A comprehensive meta-analysis of prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke was performed on the peer-reviewed epidemiologic literature through August 2015.

? Overall, summary associations indicate that intake of up to 1 egg daily may be associated with reduced risk of total stroke.

? Overall, summary associations show no clear association between egg intake and increased or decreased risk of CHD.

? Eggs are a relatively low-cost and nutrient-dense whole food that provides a valuable source of protein, essential fatty acids, antioxidants, choline, vitamins, and minerals.     

Effects of energy-dense nutrient-poor snacks on the incidence of metabolic syndrome: A prospective approach in Tehran Lipid and Glucose Study

ObjectivesIncreased consumption of energy-dense, nutrient-poor snacks is one of the major, growing concerns in relation to the alarming trend of overweight, obesity, and metabolic disorders worldwide. The aim of this study was to investigate whether consumption of energy-dense snacks could affect the occurrence of metabolic syndrome after 3 y of follow-up in adults.MethodsThis longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study between 2006 and 2008 and 2009 and 2011, on 1466 adults, ages 19 to 70 y. The usual intake of participants was measured using a validated semiquantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were assessed at baseline and 3 y later. Multiple logistic regression models were used to estimate the occurrence of metabolic syndrome (MetS) in each quartile of energy-dense snacks.ResultsParticipants in the highest quartile of energy-dense snack consumption were significantly younger (33.8 versus 43.1 y; P < 0.01). There were non-significant increased risks for MetS in the highest quartile of biscuits and cakes (odds ratio [OR], 1.13; 95% confidence interval [CI], 0.77–1.66), and candies and chocolates (OR, 1.31; 95% CI, 0.88–1.94). The risk for MetS in participants with highest consumption of salty snacks increased more than 50% (OR, 1.56; 95% CI, 1.01–2.40). Consumption of soft drinks had a borderline effect on the risk for MetS. More than 361 kcal/d from total energy-dense snacks independently increased the occurrence of MetS in the fourth compared the first quartile category (OR, 1.53; 95% CI, 1.03–2.29).ConclusionThe findings of this study demonstrated that higher consumption of energy-dense snacks could be a dietary risk factor for development of MetS.     

Energy expenditure and estimated caloric intake in asthmatic adolescents with excess body weight

ObjectiveTo measure resting energy expenditure (REE) and to estimate caloric intake of asthmatic adolescents with excess body weight and compare results with those groups of eutrophic asthmatic adolescents and non-asthmatic adolescents with excess body weight.MethodsThis cross-sectional study categorized 69 adolescents aged 10 to 18 y into three matched groups. Nutritional status was assessed using anthropometric and body composition measurements. Indirect calorimetry was used to measure energy expenditure, and caloric intake was estimated from dietary recalls.ResultsIn each group, there were 23 adolescents (10 girls) aged 12.39 ± 2.40 y. Results for each group were as follows. For asthmatic adolescents with excess body weight, body mass index (BMI) was 24.83 ± 2.73 kg/m², REEs were 1550.24 ± 547.23 kcal/d and 27.69 ± 11.33 kcal · kg^?1 · d^?1, and estimated caloric intake was 2068.75 ± 516.66 kcal/d; for eutrophic asthmatic adolescents, BMI was 19.01 ± 2.10 kg/m², REEs were 1540.82 ± 544.22 kcal/d and 36.65 ± 15.04 kcal · kg^?1 · d^?1, and estimated caloric intake was 2174.05 ± 500.55 kcal/d; and for non-asthmatic adolescents with excess body weight, BMI was 25.35 ± 3.66 kg/m², REEs were 1697.24 ± 379.84 kcal/d and 28.18 ± 6.70 kcal · kg^?1 · d^?1, and estimated caloric intake was 1673.17 ± 530.68 kcal/d. Absolute REE values between groups were not statistically different, even after correction for lean mass and fat mass (F = 0.186, P = 0.831). REE (kilocalories per kilogram per day) was significantly higher in the group of eutrophic asthmatic adolescents (P = 0.016). Estimated caloric intake was greater than REE only in the group of adolescents with asthma.ConclusionThe REE was not significantly different among groups, and REE (kilocalories per kilogram per day) was higher in the group of eutrophic asthmatic adolescents. Estimated caloric intake was greater than REE in the group of adolescents with asthma.     

Moderate replacement of carbohydrates by dietary fats affects features of metabolic syndrome: A randomized crossover clinical trial

ObjectiveEarlier studies on the management of metabolic syndrome (MetS) have mostly focused on very low carbohydrate diets, whereas long-term adherence to such diets is difficult for apparently healthy people. The aim of this study was to examine the effects of moderate replacement of carbohydrates by dietary fats on insulin resistance and features of MetS among women.MethodsThis randomized crossover clinical trial was performed with 30 overweight or obese (body mass index [BMI] > 25 kg/m²) women with MetS. After a 2-wk run-in period, participants were randomly assigned to consume either a calorie-restricted high-carbohydrate (HC) diet (60%–65% of energy from carbohydrates and 20%–25% from fats) or a calorie-restricted moderately restricted carbohydrate (MRC) diet (43%–47% of total calories as carbohydrate and 36%–40% as dietary fats) for 6 wk. Protein contents of both diets were 15% to 17% of total energy. A 2-wk washout period was applied following which participants were crossed over to the alternate treatment arm for an additional 6 wk. Anthropometric, blood pressure, and biochemical measurements were performed before and after each phase of intervention.ResultsMean age and BMI of study participants was 42.4 y and 33 kg/m², respectively. A trend toward greater reduction in waist (−3.9 versus −2.6 cm; P = 0.07) and hip circumferences (−2.7 versus −1.5 cm; P = 0.07) as well as serum triglyceride (TG) levels (−31.3 versus 0.13 mg/dL; P = 0.07) was observed after consumption of an MRC diet compared with an HC diet. The TG to high-density lipoprotein cholesterol (HDL-C) ratio had a tendency to improve with the MRC diet rather than the HC diet (−0.9 versus −0.1; P = 0.06). Consumption of the MRC diet resulted in a greater reduction of systolic blood pressure (−8.93 versus −2.97 mm Hg; P = 0.06) and diastolic blood pressure (−12.7 versus −1.77 mm Hg; P = 0.001) compared with the HC diet. The prevalence of MetS was significantly decreased following the consumption of the MRC diet (P = 0.03). The two diets were not significantly different in terms of their effect on fasting plasma glucose, serum HDL-C, low-density lipoprotein cholesterol, and total cholesterol, insulin levels, and Homeostasis Model Assessment-Insulin Resistance.ConclusionModerate replacement of carbohydrates by dietary fats was not associated with statistically different changes in fasting plasma glucose, insulin, or atherogenic dyslipidemia among individuals with the metabolic syndrome; however, it resulted in decreased diastolic blood pressure and lower prevalence of the metabolic syndrome.     

Fruit and vegetable intake and related nutrients are associated with oxidative stress markers in middle-aged men

ObjectiveThe aim of this cross-sectional study was to assess the potential relationships between fruit and vegetable (FV) intake and oxidative stress markers in middle-aged men, with an emphasis on vitamin C, fiber, and magnesium content.MethodsThe study was conducted with 296 healthy men, age 50.5 ± 5.0 y, and body mass index (BMI) of 25.8 ± 3.5 kg/m². Dietary intake, anthropometry, blood pressure, lifestyle features, and blood and urine biochemical data were assessed with validated procedures. The oxidative stress markers selected were plasma oxidized low-density lipoprotein (ox-LDL), urinary 8-iso-prostaglandin F2 α (8-iso-PGF2 α) and 8-hydroxy-2′-deoxyguanosine (8-OHdG).ResultsThe men included in the highest tertile of FV intake (≥341.1 g/d) displayed lower concentrations of ox-LDL, 8-iso-PGF2 α and 8-OHdG (P for trend < 0.05), regardless of confounding factors. Concentrations of ox-LDL were negatively associated with fiber from the FV intake (P for trend < 0.05) regardless of confounding factors. ox-LDL and 8-OHdG concentrations tended to be lower in the higher tertile of magnesium (P for trend = 0.06) and vitamin C from FV intake (P for trend = 0.05), respectively. Additionally, concentrations of 8-iso-PGF2 α were lower in men in the highest tertile of fiber (≥6.5 g/d; P for trend = 0.034), vitamin C (≥98.0 mg/d; P for trend = 0.007), and magnesium (≥48.9 mg/d; P for trend = 0.018) from the FV-group intake.ConclusionsGreater FV intake was independently associated with reduced ox-LDL, 8-OHdG, and 8-iso-PGF2 α in middle-aged men. Fiber, vitamin C, and magnesium from FV seem to contribute to this beneficial relationship.     

Association between interaction and ratio of ω-3 and ω-6 polyunsaturated fatty acid and the metabolic syndrome in adults

ObjectiveTo investigate the association of the intakes of ω-3 (including α-linolenic acid [ALA], eicosapentaenoic acid [EPA] plus docosahexaenoic acid [DHA]) and ω-6 polyunsaturated fatty acids (PUFAs), the interaction, and the ratio of these PUFAs with the metabolic syndrome (MetS) in adults.MethodsThis cross-sectional study was conducted in a random sample of participants (n = 2451, 19–84 y old) in the Tehran Lipid Glucose Study. Dietary intake was assessed using a validated semiquantitative food-frequency questionnaire. Anthropometric characteristics, blood pressure, and fasting plasma concentrations of glucose and lipids were measured. The MetS was defined according to the Adult Treatment Panel III guidelines.ResultsAmong the PUFAs, the ALA and ω-6 PUFA intakes were inversely associated with the MetS. Subjects in the highest quartile of ALA and ω-6 fatty acid intakes had a 38% (odds ratio 0.62, 95% confidence interval 0.41–0.95) and a 0.47% (odds ratio 0.53, 95% confidence interval 0.31–0.89) lower prevalence of MetS, respectively, compared with those in the lowest quartile. The dietary ratio of ω-6 to ω-3 fatty acids was not associated with the MetS. When the interaction between ALA and ω-6 fatty acid was assessed, the ALA intake was associated with a lower prevalence of the MetS, without modification by the ω-6 PUFA intake. Subjects with at least the median ALA intake (1084 mg/d) had a lower prevalence of the MetS, irrespective of an ω-6 PUFA intake lower or higher than the median compared with subjects with intakes below the median for both.ConclusionThe ALA intake was inversely associated with the MetS, irrespective of the background intake of ω-6 PUFAs, in adults.     

Effects of Egg Consumption and Choline Supplementation on Plasma Choline and Trimethylamine-N-Oxide in a Young Population

ABSTRACT

Background: Plasma trimethylamine-N-oxide (TMAO) concentrations have been associated with cardiovascular disease risk. Eggs are a rich source of choline, which is a precursor of TMAO.

Objective: The effects of egg intake versus daily choline supplementation were evaluated on plasma choline and TMAO in a young, healthy population.

Methods: Thirty participants (14 males, 16 females; 25.6 ± 2.3 years; body mass index = 24.3 ± 2.9 kg/m²) were enrolled in this 13-week crossover intervention. After a 2-week washout, participants were randomized to consume either 3 eggs/d or a choline bitartrate supplement (～ 400 mg choline total in eggs or supplement) for 4 weeks. Following a 3-week washout, participants were switched to the alternate treatment. Dietary records were measured at the end of each period. Plasma TMAO and choline were measured at baseline and at the end of each dietary intervention. Gene expression of scavenger receptors associated with plasma TMAO were quantified at the end of each intervention.

Results: Compared to the choline supplement, intake of total fat, cholesterol, selenium, and vitamin E were higher (p < 0.05), whereas carbohydrate intake was lower (p < 0.001) with consumption of 3 eggs/d. Fasting plasma choline increased 20% (p = 0.023) with egg intake, while no changes were observed with choline supplementation. Plasma TMAO levels were not different between dietary treatments or compared to baseline.

Conclusions: Dietary choline appears to be more bioavailable via egg consumption when compared to a choline supplement. Plasma TMAO concentrations were not affected in healthy participants after 4 weeks of taking ～400 mg/d choline either via eggs or choline supplementation.     

Folate intake and folate serum levels in men and women from two European populations: The IMMIDIET project

ObjectiveFolate status has been associated with neural tube defects and cerebrovascular disease. The aim of this study was to evaluate possible differences in folate status in two European Union countries and to assess their possible association with dietary patterns and/or other lifestyles.MethodsIn the framework of the European Union-funded IMMIDIET Project, 1068 individuals (534 male–female pairs), ages 26 to 64 y, were enrolled in Italy and the United Kingdom. One-year-recall food frequency questionnaire was used to evaluate dietary intake. Reduced rank regression analysis was used to derive a dietary pattern better describing high dietary folate intake.ResultsOf the total participants, 11.3% of the Italians and 45.1% of the British exceeded the optimal dietary folate intake of 400 μg/d (Recommended Dietary Allowance). Of the women, 66.7% and 22.1% of Italian and British women, respectively, all at childbearing age, had folate serum levels <6.62 ng/mL (P = 0.01). The percentage of total variance of dietary folate intake explained by food group consumption was 14.2% and 16.3% in Italy and the United Kingdom, respectively. Reduced rank regression analysis indicated a healthy pattern that was positively associated with folate serum levels in both countries (for all β-coefficients >0; P < 0.001): 100 μg/d increase in dietary folate intake was associated with 13.8% and 10.5% increase in folate serum levels in the Italian and British population, respectively (for 100 μg/d increase e^β-coef = 1.138 and 1.105; P < 0.001). Smoking habit was negatively but physical activity positively associated with folate serum levels (P < 0.05).ConclusionsAn inadequate dietary folate intake and subsequent serum levels were observed in the Italian participants. High consumption of food sources of folate was positively associated with folate serum levels, explaining a good proportion of its variability.     

Egg Intake and Dietary Quality among Overweight and Obese Mexican-American Postpartum Women

Despite their low cost and high nutrient density, the contribution of eggs to nutrient intake and dietary quality among Mexican-American postpartum women has not been evaluated. Nutrient intake and dietary quality, as assessed by the Healthy Eating Index 2010 (HEI-2010), were measured in habitually sedentary overweight/obese (body mass index (BMI) = 29.7 ± 3.5 kg/m²) Mexican-American postpartum women (28 ± 6 years) and compared between egg consumers (n = 82; any egg intake reported in at least one of three 24-h dietary recalls) and non-consumers (n = 57). Egg consumers had greater intake of energy (+808 kJ (193 kcal) or 14%; p = 0.033), protein (+9 g or 17%; p = 0.031), total fat (+9 g or 19%; p = 0.039), monounsaturated fat (+4 g or 24%; p = 0.020), and several micronutrients than non-consumers. Regarding HEI-2010 scores, egg consumers had a greater total protein foods score than non-consumers (4.7 ± 0.7 vs. 4.3 ± 1.0; p = 0.004), and trends for greater total fruit (2.4 ± 1.8 vs. 1.9 ± 1.7; p = 0.070) and the total composite HEI-2010 score (56.4 ± 12.6 vs. 52.3 ± 14.4; p = 0.082). Findings suggest that egg intake could contribute to greater nutrient intake and improved dietary quality among postpartum Mexican-American women. Because of greater energy intake among egg consumers, recommendations for overweight/obese individuals should include avoiding excessive energy intake and incorporating eggs to a nutrient-dense, fiber-rich dietary pattern.     

Carbohydrate Intake Interacts With SNP276G>T Polymorphism in the Adiponectin Gene to Affect Fasting Blood Glucose,HbA1C,and HDL Cholesterol in Korean Patients With Type 2 Diabetes

Background/Objective: The SNP276G>T polymorphism in the adiponectin gene has been reported to be associated with type 2 diabetes and impaired glucose tolerance. The objective of this study was to examine whether SNP276G>T polymorphism influences the blood glucose levels in relation to dietary carbohydrate intake.

Subjects/Methods: In an ongoing, prospective study, 673 patients with type 2 diabetes (339 men and 334 women, aged 40–85 years) were recruited from one of two diabetes clinics in Seoul, Korea. The levels of carbohydrate intake were categorized as <55%, 55%–65%, and >65% of total energy intake.

Results: Significant gene–nutrient interactions between SNP276G>T polymorphism and the level of carbohydrate intake were found, which modulated plasma fasting blood glucose ( p = 0.0277), HbA1C ( p = 0.0407), and high-density lipoprotein (HDL) cholesterol ( p = 0.0134) concentrations. The G allele was associated with higher fasting blood glucose only in subjects consuming a low-carbohydrate diet (<55% of energy). However, when carbohydrate intake was intermediate (55%–65%), carriers of the T allele had greater fasting blood glucose and HbA1C concentrations. When carbohydrate intake was high (>65%), carriers of the T allele had greater HDL cholesterol concentrations. This interaction was significant even when carbohydrate intake was considered a continuous variable ( p = 0.0200 for fasting blood glucose, p = 0.0408 for HbA1C, and p = 0.0254 for HDL cholesterol), suggesting a strong dose–response relation.

Conclusions: Our data show that the effect of the SNP276G>T polymorphism on plasma fasting blood glucose, HbA1C, and HDL cholesterol concentrations depends on dietary carbohydrate intake.     

Associations Between Ultra-processed Foods Consumption and Indicators of Adiposity in US Adolescents: Cross-Sectional Analysis of the 2011-2016 National Health and Nutrition Examination Survey

BackgroundUltra-processed foods represent a considerable part of the diet of US children and adolescents, yet their association with total, abdominal, and visceral overweight/obesity remains understudied.ObjectiveTo examine associations between dietary contribution of ultra-processed foods and total, abdominal, and visceral overweight/obesity in a nationally representative sample of US adolescents.DesignCross-sectional analyses were performed on data collected from adolescents participating in the 2011-2016 National Health and Nutrition Examination Survey.Participants/settingParticipants included 3587 adolescents aged 12 to 19 years, who had data from at least 1 day of valid 24-hour dietary recall data.Main outcome measuresTotal overweight/obesity, abdominal overweight/obesity, and visceral overweight/obesity data were collected.Statistical analyses performedAll food items (grams per day) recorded in the 24-hour recalls were classified according to Nova. Multiple logistic regressions were used to evaluate associations between the dietary contribution of ultra-processed foods (expressed in percentage of total grams per day) and outcomes. Multivariable models were adjusted for sociodemographic covariates, physical activity, total energy intake, whether the individual was following a special diet for weight loss, and indicators of the nutritional quality of the diet.ResultsIn multivariable analyses, the highest consumption of ultra-processed food was associated with 45%, 52%, and 63% higher odds of total, abdominal, and visceral overweight/obesity, respectively (odds ratio [OR] 1.45, 95% CI 1.03-2.06, P for linear trend = .040; OR 1.52, 95% CI 1.06-2.18, P for linear trend = .026; OR 1.63, 95% CI 1.19-2.24, P for linear trend = .005, respectively), compared with the lowest consumption. A 10% increment in the proportion of ultra-processed foods in the diet was associated with an increased risk of both abdominal overweight/obesity (OR 1.07; 95% CI 1.01-1.13) and visceral overweight/obesity (OR 1.07; 95% CI 1.02-1.13).ConclusionsStudy findings support the growing evidence of cross-sectional and prospective associations between ultra-processed foods and increased adiposity and also with metabolically unhealthy phenotypes of obesity in adolescence. Timely action to reduce the consumption of ultra-processed foods among adolescents is needed.     

Habitual coffee consumption inversely associated with metabolic syndrome-related biomarkers involving adiponectin

ObjectivesThe goal of this cross-sectional study was to assess whether habitual coffee consumption shows beneficial association with metabolic syndrome (MetS) in adults.MethodsThe association of coffee consumption and MetS-related biomarkers including visceral fat area (VFA) and subcutaneous fat area (SFA), total serum adiponectin (T-Ad), low-molecular-weight serum adiponectin (LMW-AD), medium-molecular-weight serum adiponectin (MMW-Ad), and high-molecular-weight serum adiponectin (HMW-Ad) levels were analyzed among 364 Japanese men (36–61 y old) using two models of multivariate regression analyses; model 1 (adjusted for age, alcohol drinking, smoking, and walking status) and model 2 (adjusted for body mass index in addition to model 1 analysis). Participants were categorized into two groups according to their MetS risk score (raised blood pressure and hemoglobin A_1c levels, and reduced high-density lipoprotein cholesterol levels).ResultsBoth light (1–3 cups/d) and moderate (≥4 cups/d) coffee consumption showed significant inverse associations with VFA and VFA/SFA ratio (P < 0.0001). Moderate coffee consumption showed a favorable tendency toward these associations with T-Ad (P = 0.06) and HMW-Ad (P = 0.07) levels in model 1 analysis. In participants with lower MetS risk score (≤1), moderate coffee consumption showed significant associations with T-Ad and HMW-Ad levels (P < 0.05) in both analyses, whereas no significant associations of coffee consumption with adiponectin levels were seen in the men with higher MetS risk scores (≥2).ConclusionsHabitual moderate coffee consumption shows significant inverse associations with MetS-related biomarkers possibly involving adiponectin, which is inversely related to visceral fat accumulation.     

Maternal intake of fried foods and risk of gestational diabetes mellitus

PurposeWe examined the relationship of maternal periconceptional (i.e., before conception and early pregnancy) intake of fried foods with gestational diabetes mellitus (GDM) risk.MethodsIn a prospective birth cohort in Seattle and Tacoma, Washington State, USA, we assessed maternal periconceptional fried food intake using a food frequency questionnaire among 3414 participants. We used multivariable generalized linear regression models to derive estimates of relative risks (RRs; and 95% confidence intervals, 95% CIs) of GDM in relation to the intake of different types of fried foods (i.e., fried fish, fried chicken, fried potatoes, chips, and donuts).ResultsA total of 169 GDM incident cases were identified in this cohort (4.96%). Compared with no fried fish intake, fried fish intake >1 servings/month was associated with 68% higher GDM risk (adjusted RR and 95% CI; 1.68 [1.16, 2.45]; P_trend = .019). After adjusting for confounders, the RRs (95% CI) of GDM relative to fried chicken intake were 1.0, 1.44 (0.98, 2.09), and 1.81 (1.22, 2.70) for none, ≤1 and > 1 servings/month intake of fried chicken, respectively (P_trend = .002). Dietary intake of fried potatoes, snack chips or donuts was not significantly associated with higher GDM risk. Limitations of our study include the lack of information about frying methods and the intake of fried foods at home and away from home.ConclusionsRegular intake of fried fish and fried chicken are associated with elevated GDM risk.     

Vegetarianism produces subclinical malnutrition, hyperhomocysteinemia and atherogenesis

ObjectiveTo explain why vegetarian subjects develop morbidity and mortality from cardiovascular diseases unrelated to vitamin B status and Framingham criteria.MethodsA study of 24 rural male subjects 18 to 30 y old and 15 urban male controls was conducted in the Sahel region of Chad. Food consumption was determined from a dietary questionnaire, and overall health status was assessed by body weight, body mass index, serum albumin, plasma transthyretin, urinary nitrogen, and creatinine. Plasma lipids, vitamins B6, B9 and B12, homocysteine, and related sulfur amino acids were measured as selected cardiovascular disease risk factors.ResultsBody weight, body mass index, blood, and urinary markers of protein status were significantly lower, with an estimated 10% decrease of lean body mass in the study group compared with urban controls. Neither lipid fractions nor plasma levels of vitamins B6, B9, and B12 were significantly different between the two groups. Although the mean consumption of sulfur amino acids (10.4 mg·kg^?1·d^?1) by rural subjects was significantly below the recommended dietary allowances (13 mg·kg^?1·d^?1), plasma methionine values were similar in the two groups. In contrast, homocysteine concentration was significantly increased (18.6 μmol/L, P < 0.001), and the levels of cysteine and glutathione were significantly decreased in the study group, demonstrating inhibition of the trans-sulfuration pathway. The strong negative correlation (r = ?0.71) between transthyretin and homocysteine implicated lean body mass as a critical determinant of hyperhomocysteinemia.ConclusionThe low dietary intake of protein and sulfur amino acids by a plant-eating population leads to subclinical protein malnutrition, explaining the origin of hyperhomocysteinemia and the increased vulnerability of these vegetarian subjects to cardiovascular diseases.     

Tea consumption is inversely associated with weight status and other markers for metabolic syndrome in US adults

Purpose

Tea (Camellia sinensis) is a widely consumed beverage, and laboratory and some intervention studies have indicated the potential health benefits of hot tea. The present study examines the association between tea consumption (evaluating hot and iced tea independently) and markers for metabolic syndrome adults in a sample of 6,472 who participated in the 2003–2006 National Health and Nutrition Examination surveys.

Methods

Tea consumption was evaluated using food frequency questionnaires and 24-h dietary recalls. Seventy percent of the sample reported any consumption of iced tea and 16 % were daily consumers, whereas approximately 56 % of this sample reported hot tea consumption and 9 % were daily consumers.

Results

Hot tea consumption was inversely associated with obesity: tea consumers had lower mean waist circumference and lower BMI (25 vs. 28 kg/m² in men; 26 vs. 29 kg/m² in women; both P < 0.01) than non-consumers after controlling for age, physical activity, total energy intake, and other confounders. For iced tea consumption, the association was reversed: increased iced tea consumption was associated with higher BMI, greater waist circumference, and greater subcutaneous skinfold thickness after controlling for age, physical activity, energy intake, sugar intake, and other confounders. Hot tea consumption was associated with beneficial biomarkers of cardiovascular disease risk and inflammation (increased high-density lipoprotein-associated cholesterol and decreased C-reactive protein in both sexes, and reduced triglycerides in women), whereas the association with iced tea consumption was again reversed.

Conclusions

These cross-sectional results support growing laboratory data, which demonstrate the negative association of hot tea intake with markers of MetS.     

Eggs Improve Plasma Biomarkers in Patients with Metabolic Syndrome Following a Plant-Based Diet—A Randomized Crossover Study

Plant-based (PB) diets are considered a healthy dietary pattern; however, eggs are not always included in this dietary regime. We hypothesized that the addition of two eggs per day would increase HDL cholesterol as well as plasma lutein, zeaxanthin and choline in individuals with metabolic syndrome (MetS). In this randomized controlled crossover intervention, we recruited 30 participants (49.3 ± 8 y) with MetS who followed a PB diet for 13 weeks. A registered dietitian advised all subjects on food selection and followed them through the intervention to ensure compliance. Participants underwent a 2-week washout with no eggs or spinach (a source of dietary lutein and zeaxanthin) and were randomly allocated to consume spinach (70 g) with either two eggs (EGG) or the equivalent amount of egg substitute (SUB) for breakfast for 4 weeks. After a 3-week washout, they were allocated the alternate breakfast. A total of 24 participants (13 women/11 men) finished the intervention. Plasma lipids, glucose, insulin, anthropometrics, plasma lutein, zeaxanthin, choline and trimethylamine oxide (TMAO) were assessed at baseline and the end of each intervention. When we compared individuals consuming the EGG versus the SUB breakfast, we observed a lower body weight (p < 0.02) and a higher HDL cholesterol (p < 0.025) after the EGG diet. There were no differences in plasma LDL cholesterol, triglycerides, glucose, insulin, or blood pressure. The number of large HDL particles measured by NMR was higher after EGG (p < 0.01) as compared to SUB. Plasma choline was higher in both treatments (p < 0.01) compared to baseline (8.3 ± 2.1 μmol/L). However, plasma choline values were higher in EGG (10.54 ± 2.8 μmol/L) compared to SUB (9.47 ± 2.7 μmol/L) p < 0.025. Both breakfasts increased plasma lutein compared to baseline (p < 0.01), while plasma zeaxanthin was only increased in the egg intervention (p < 0.01). These results indicate that consuming a plant-based diet in combination with whole eggs increases plasma HDL cholesterol, choline and zeaxanthin, important biomarkers in subjects with MetS.     

Dietary polyphenols and metabolic syndrome among Iranian adults

Abstract

Aim: The aim of this study was to investigate the association between total polyphenol intake, its subclasses (including flavonoids, phenolic acids, stilbenes and lignans), and the metabolic syndrome (MetS). Methods: This population-based cross-sectional study was conducted on a representative of 2618 adults, aged 19 to 84 years. Dietary intake was assessed using a validated food-frequency questionnaire and intakes of total polyphenol and four main subclasses of polyphenol including flavonoids, phenolic acids, stilbenes and lignans were determined. Results: Higher consumption of flavonoid intakes was associated with lower odds of enlarged waist circumference, hypertriglyceridemia, low HDL cholesterol, hyperglycemia, hypertension and MetS. Subjects in the highest quartile of lignan intakes had higher odds of having hypertriglyceridemia and hyperglycemia. Subjects in the highest quartile of stilbene intakes had higher odds of having hypertension. Conclusion: Intakes of selected subclasses of polyphenol such as flavonoids are associated with a lower prevalence of MetS among Tehranians.     

Reliability and Validity of a Modified MEDFICTS Dietary Fat Screener in South African Schoolchildren Are Determined by Use and Outcome Measures

BackgroundIn South Africa, noncommunicable diseases and obesity are increasing and also affect children. No validated assessment tools for fat intake are available.ObjectiveTo determine test–retest reliability and relative validity of a pictorial modified meats, eggs, dairy, fried foods, fats in baked goods, convenience foods, table fats, and snacks (MEDFICTS) dietary fat screener.DesignWe determined test–retest reliability and diagnostic accuracy with the modified MEDFICTS as the index test and a 3-day weighed food record and parental completion of the screener as primary and secondary reference methods, respectively.Participants/settingGrade-six learners (aged 12 years, 4 months) in an urban, middle-class school (n=93) and their parents (n=72).Outcome measuresPortion size, frequency of intake, final score, and classification of fat intake of the modified MEDFICTS, and percent energy from fat, saturated fatty acids, and cholesterol of the food record.Statistical analysesFor categorical data agreement was based on kappa statistics, McNemar's test for symmetry, and diagnostic performance parameters. Continuous data were analyzed with correlations, mean differences, the Bland-Altman method, and receiver operating characteristics.ResultsThe classification of fat intake by the modified MEDFICTS was test–retest reliable. Final scores of the group did not differ between administrations (P=0.86). The correlation of final scores between administrations was significant for girls only (r=0.58; P=0.01). Reliability of portion size and frequency of intake scores depended on the food category. For girls the screener final score was significantly (P<0.5) correlated to total, saturated fat, and cholesterol intakes (but not to percent energy from fat and saturated fatty acids intakes). The sensitivity of the modified MEDFICTS was very high (>90%), but chance corrected agreement between the classifications was poor. Parents did not agree with their children.ConclusionsTest–retest reliability and relative validity of a modified MEDFICTS dietary fat screener in South African schoolchildren depended on the use and outcome measures applied.     

Dietary consumption of advanced glycation end products and risk of metabolic syndrome

Metabolic syndrome (MetS) is a complex disorder which has become one of the major public health challenges worldwide. This study was conducted to evaluate the association between dietary advanced glycation end products (AGEs) and risk of MetS and its components. This cross-sectional study was conducted in a representative sample of 5848 adults, aged 19–70 years. Daily consumption of carboxymethyl lysine, a major type of AGEs, was determined using a validated semi-quantitative food frequency questionnaire. Across increasing trend of AGEs consumption, the percentage of fat intake increased and that of carbohydrate significantly decreased (p?<?0.001). Subjects in the highest (>10 506 kU/d) compared to the lowest (<6673 kU/d) quartile category of AGEs had higher risk of abdominal obesity (OR: 1.19, 95% CI: 1.01–1.39) and hypertriglyceridemia (OR: 1.26, 95% CI: 1.07–1.49). Therefore, recommendation on restriction of AGEs intake could be a practical approach to prevent metabolic abnormalities.